CN108348358B

CN108348358B - Bandage for fixing or holding a joint

Info

Publication number: CN108348358B
Application number: CN201680064199.1A
Authority: CN
Inventors: D·米勒
Original assignee: Millet Innovation SA
Current assignee: Millet Innovation SA
Priority date: 2015-11-06
Filing date: 2016-10-12
Publication date: 2021-06-22
Anticipated expiration: 2036-10-12
Also published as: PT3370663T; JP6999547B2; HUE046970T2; DK3370663T3; JP2018535729A; BR112018007641B1; BR112018007641A2; AU2016347778A1; US20180325742A1; PL3370663T3; AU2016347778B2; CA3001988A1; WO2017077206A1; EP3370663A1; FR3043321A1; CN108348358A; AU2016347778A2; EP3370663B1; ES2765482T3

Abstract

The invention relates to a holding or immobilisation device configured to encircle a limb or joint of a user, comprising an elastic band (1) having two band sections (10, 20) with different stiffness values, the elastic band comprising an inner surface (15) in contact with the area covered by the band and an outer surface (14) opposite to the inner surface, the inner surface of the band providing attachment to the covered area in the presence of an immobilisation pressure exerted when the band is placed tightly around the limb or joint, such that the two sections of the band can retain an elongation caused by different traction forces after the traction forces are removed.

Description

Bandage for fixing or holding a joint

Technical Field

The invention relates to a joint compression or support device which compresses a specific limited region of the body, in particular in the case of ligament or muscle weakness or circulatory pathologies or post-operative conditions. The invention is particularly suitable for use in the extremities as well as in the knee, ankle, shoulder, elbow, wrist and hip joints.

Background

Compression bands exist which are intended to be used in post-operative conditions of the lower extremities, in particular to limit hematoma formation and/or circulatory pathologies, or to prevent the risk of damaging muscle or joint tissue.

There are also back support belts designed to wrap around the waist or chest forming several overlapping turns. These bands are generally made of an elastic fabric, most often a knitted fabric, and have adjustable clamping means and markings for adjusting tightness according to the physician's recommendations. These bands exert equal pressure over the entire coverage area. It was also confirmed that these bands tended to slide along the limbs.

However, in several regions of the body, it may be desirable to apply pressure locally while avoiding sensitive areas. Thus, in the foot example, three areas are particularly sensitive to pressure. These areas are the dorsal arch, the tibial tarsal region, and the achilles tendon region of the foot. In fact, excessive pressure on these areas may cause pain or trauma. It should also be noted that the ankle dorsiflexion (upward pivoting of the foot) required to engage the step is produced by contraction of the levator muscles of the foot (tibialis anterior, extensor brevis and extensor longus of the toes). Contraction of these muscles results in a bulging of the tendon, particularly the tibialis anterior. Thus, applying too much pressure in this raised tendon region can result in intolerable pain and potential tendinopathy. In addition, excessive compression of arteries and nerves, particularly the dorsalis pedis arteries and nerves located on the dorsal arch of the foot, can also lead to inadequate tissue oxygenation and paresthesia. Excessive compression also has an effect on blood circulation in the ankle-surrounding area of the tibia. The compression band does not allow to apply sufficient pressure on the area to be held while avoiding the application of pressure on the sensitive area.

Devices in the form of belts for adjusting and locking the hook and loop elements

Provided is a method. Furthermore, such belts cannot exert a pressure that can be varied and adjusted according to the area covered. Moreover, in addition to their unattractive appearance, the elements with loops and hooks are relatively thick and stiff, which can be inconvenient from a movement-impeding perspective, especially if the belt is worn inside a joint and shoe. The thickness of the loop and hook elements can also interfere with or prevent the wearing of tight fitting garments. In addition, the garment worn on the straps may be damaged by the hook elements, the hooks of which may catch on the mesh or braid of the fabric forming the garment.

Adjustment of the pressure applied by such a strap is also difficult for the loop and hook elements, as it cannot be gradual. In fact, in order to vary the pressure, it is necessary to completely separate the two elements and to bond them again in another position. Generally, the user must readjust the pressure multiple times before achieving the desired adjustment.

There are also devices in the form of socks or knitted sleeves, the knitting of which is selectively carried out in the loops to locally exert different pressures depending on the annular zone covered. As a result, these devices may locally have a relatively large thickness, which may prevent the wearing of tight fitting garments. These devices also have the disadvantage of requiring a large number of different sizes to be manufactured to suit different attitudes of the user.

There are also non-elastic or low-elastic adhesive strips designed to be wound several turns around a limb to partially immobilize the joint or to compact muscles, especially in sports or post-operative situations. These adhesive tapes also have the disadvantage of applying a uniform pressure over the entire covered area. In addition, they must be disposable.

It is therefore desirable to provide a device for supporting a joint or compressing a portion of a limb that can selectively apply adjustable pressure locally depending on the coverage area. It may also be desirable that such a device be reusable and adaptable to a variety of body conditions without the need to provide a large number of different sizes.

Disclosure of Invention

The present invention relates to a support (retention) or compression (immobilization) device configured to encircle a limb or joint of a user, comprising an elastic band (bandage) having two band segments of different stiffness values, the elastic band having an inner surface in contact with the area covered by the band and an outer surface opposite the inner surface, the inner surface of the band providing attachment to the covered area in the presence of compression pressure applied when the band is placed around the limb or joint under traction, such that the two segments of the band can retain elongation (stretching) caused by different traction forces after removal of the traction forces.

According to one embodiment, a first of the two strap sections comprises a pad made of elastic material attached to the strap by two opposite ends.

According to one embodiment, the pad is attached to the inner surface of the support means.

According to one embodiment, the pad is attached to the outer surface of the support means.

According to one embodiment, the pad comprises a layer of viscoelastic material and an elastic textile layer attached to the layer of viscoelastic material.

According to one embodiment, the elastic fabric layer has a lower stiffness in the longitudinal direction of the belt than in the transverse direction.

According to one embodiment, a first of the two strap sections has a stiffness between 2 and 4 times that of a second of the two strap sections.

According to one embodiment, the inner surface is formed by a layer of polymer gel, such as polydimethylsiloxane.

According to one embodiment, the elastic band is configured in the form of a sleeve.

According to one embodiment, the inner surface of the band has an adhesion to the covered area that can maintain the elongation caused by the pulling force differing by 20N in the presence of the compressive pressure applied when the band is placed around a component or joint under traction.

According to one embodiment, the device comprises a first and a second strap part configured to be wrapped around the ankle and the foot, the first strap part comprising a first strap section having a higher stiffness than the other strap sections of the first strap part, the second strap part having an end portion secured to the outer surface of the first part and a second strap section having a higher stiffness than the other strap sections of the second strap part, wherein the first and second strap sections having the higher stiffness are arranged on the strap parts such that they can cover both the area below and above the lateral malleolus of the ankle as well as the medial malleolus.

The invention may also relate to a method of manufacturing a support or compression device configured to encircle a limb or joint of a user as previously described.

The invention may also relate to a method of using a support device as described above, the method comprising the steps of: fitting a support device around a limb or joint; applying a higher tension to a first of the strap sections of the support device, which has a higher stiffness than a second strap section of the support device, and applying a lower tension to the second strap section of the support device to elongate the first and second sections; and removing the pulling forces.

According to one embodiment, the support device comprises first and second strap portions configured to wrap around the ankle and foot, the first strap portion comprising a first strap section having a higher stiffness than another strap section of the first strap portion, the second strap portion having an end attached to an outer surface of the first portion, the second strap section having a higher stiffness than another strap section of the second strap portion, the method comprising the steps of: attaching a first end of the first strap portion to an ankle orthosis having two rigid pads to be held on an ankle of a user's ankle; wrapping the strap portion around the ankle with a first traction force, then wrapping around the foot over the top of the foot, then wrapping under the foot to meet with one end of the first strap section; wrapping the first strap section around the foot and then applying a second traction force greater than the first traction force around the ankle to stretch the first strap section to clamp the lower portion of the first of the two pads and the second of the two pads therebetween; wrapping an end of the first strap portion around the ankle with a traction force lower than the second traction force and attaching a second end of the first strap portion; the second strap portion is wrapped around the top of the foot and then around the ankle with a traction force lower than the first traction force, the second strap portion is placed on the upper portion of the first pad, and the free end of the second strap portion is attached.

Drawings

Exemplary embodiments of the invention will now be described, without limitation, with reference to the accompanying drawings, in which:

figures 1 and 2 schematically show a cross-sectional view and a front view of a support device according to one embodiment,

figure 3 schematically shows a cross-sectional view of a support device according to another embodiment,

figures 4 and 5 are a schematic cross-sectional and front view of a support device according to another embodiment,

figure 6 schematically shows a cross-sectional view of a support device according to another embodiment,

figures 7 and 8 are graphs of the variation of the tensile force and of the stiffness as a function of the elongation of the elements forming the support means,

figures 9A and 9B are schematic cross-sectional views of a support device for engaging a limb or joint in two different configurations,

figure 10 schematically illustrates an outer side of a foot and ankle equipped with an ankle orthosis according to one embodiment,

figure 10A shows a thermoformable portion of the ankle orthosis of figure 10 according to one embodiment,

figure 11 schematically shows the medial side of the foot and ankle fitted with the orthosis shown in figure 10,

figure 11A shows another thermoformable portion of the ankle orthosis of figure 10 according to one embodiment,

figure 12 schematically shows a cross-section of a support belt according to one embodiment,

fig. 13 is a graph of the change in tension applied to the support strap of fig. 12 as it is wrapped around the foot and ankle orthosis.

Detailed Description

Fig. 1 and 2 show a support device 1 according to one embodiment. The support device 1 is in the form of a belt comprising several

elastic belt segments

10, 20, 30 having different stiffness values. For this purpose, the

belt sections

10, 20, 30 may have different thicknesses and/or may be formed from different materials. The

belt sections

10, 20, 30 may be joined together by any means, such as by welding or sewing.

The support device 1 has an outer surface 14 and an inner surface 15, which inner surface 15 is opposite to the surface 14 and is designed to contact the area covered by the support device. According to one embodiment, the inner surface 15 has a specific adherence to the covered area under the effect of the pressure exerted when the support device 1 is placed under traction around a limb or joint. This attachment to the cover area allows the

belt sections

10, 20, 30 to exert different pressures. These different pressures are obtained by subjecting the

different belt segments

10, 20, 30, respectively, to different tensile forces, which due to the adhesion of the inner surface 15 at least partly maintain their tension after these forces have been removed. This attachment depends on the nature of the contact surface, its curvature (when wrapped around the limb) and the material on the inner surface 15 of each

strap section

10, 20, 30 and the area covered by the device. Due to this attachment, anchoring areas can be obtained between which a higher compression can be applied.

Thus, the support device 1 can exert a higher pressure on the area of the limb covered by the band section 20 when it is fitted around the limb or joint and, conversely, a lower pressure on the area of the limb covered by the

sections

10, 30.

In the example of fig. 1, the band section 20 has a higher stiffness than the

band sections

10, 30. Thus, if they are subjected to the same tension, the belt sections 20 may be stretched under a relatively greater tension while stretching less than the

sections

10, 30. According to an exemplary embodiment, the stiffness of the band section 20 is between 2 and 4 times the stiffness of the

band sections

10, 30. As a result, the strap section 20 stretches between 2 and 4 times less than the

strap sections

10, 30 under the same tensile force.

According to one embodiment, the attachment of the inner surface 15 to the support device 1 is also achieved by a suitable choice of the material forming the

belt sections

10, 20, 30. According to another embodiment, the attachment is achieved by covering the inner surface 15 of the device 1 with an elastic layer consisting of a material having the desired attachment. Thus, the choice of materials forming the different strap sections is not limited by the attachment criteria. Thus, fig. 3 shows a support device 1-1 comprising an elastic layer 2 covering at least partially its inner surface 15 and exhibiting the desired adhesion. The layer 2 may be a coating of viscoelastic material distributed on the inner surface 15, for example having a uniform thickness.

Fig. 4 and 5 show a support device 1-2 according to one embodiment. The support device 1-2 is in the form of an elastic band comprising

elastic band segments

10, 20, 30 having different stiffness values. The

sections

10, 30 are formed by an elastic band 11. The section 20 is formed by attaching a pad 12 on the layer 13 of the strip 1, by two fastening lines 17 extending along two opposite edges of this pad 21. Thus, the belt section 20 has a multi-layered structure including the belt 11 and the cushion 21. The fastening lines 17 are formed on the belt 11 in the transverse direction of the belt 11. The fastening lines 17 are formed such that the pad 21 has a length between the two fastening lines 17 that substantially coincides with the length of the portion of the belt 11 below the pad between the two fastening lines 17 in a configuration in which the belt 11 and the pad 21 are not stretched.

The belt 11 may include a layer 12 of elastic material on its outer surface 14 and an elastic layer 13 of material with the desired adhesion on its inner surface 15. The layer 12 may be made of a fabric that is elastic at least in the longitudinal direction of the belt. The layer 13 may be, for example, a coating of viscoelastic material distributed in a uniform manner on the inner surface 15. The fastening thread 17 may be a seam. The pad 21 may comprise a layer 22 of viscoelastic material forming the adhesive face of the section 20 and a layer 23 of elastic fabric attached to this layer 22. The fabric layer 23 may be glued to the layer 22. The layer 22 has some adhesion so that it is prevented from sliding over the surface covered by the device 1-2 in the presence of some compression pressure. The attachment is such that the strap section 20 can be stretched under a different tension than the tension applied to the

sections

10, 30 and maintain its tension in the absence of tension due to the attachment of the layer 22 and the compressive pressure applied by the support 1-2.

The thickness of the strip 12 may be chosen to be between 0.3mm and 1.5mm, the layer 13 having a thickness of between 0.1mm and 0.5 mm. The

layers

2, 13 and 22 may be a viscoelastic polymer gel such as silicone gel (polydimethylsiloxane-PDMS), the hardness and adhesion properties of which are selected according to their respective role in the support means. The thickness of the layer 22 may be chosen to be between 0.3mm and 1 mm.

In one embodiment, the belt 10 has a width of between 5cm and 6cm, while the pad 21 is slightly narrower than the belt 10, for example about 2 to 7 mm.

Since the adhesive layer 13 is distributed over the entire surface of the belt 12, the mat 21 can be fixed to the outer surface 14 of the belt 12, as shown in fig. 6. Thus, FIG. 6 shows a support 1-3 which differs from support 1-2 only in that the pad 21 is secured to the outer surface 14 of the belt 11. As a result, the layer 13 formed on the inner surface of the belt 11 is in full contact with the area covered by the supporting means 1-3.

The support means 1, 1-2, 1-3 can be kept wrapped and stretched around the limb or joint by means of attachment means comprising two parts which are fixed to the two ends of the strap 10 respectively and which cooperate with each other to attach to each other. The attachment means may for example comprise one or more loops attached to one end of the support means and a hook attached to the other end of the support means, or a hook and loop strap attached to opposite ends of the support means

Thus, the support device 1, 1-2, 1-3 may be wrapped around the limb or joint by making more than one turn around the limb such that a portion of the inner surface 15 of the support device is in contact with a portion of the outer surface 14 of the support device. It may then be provided to cover at least a portion of the outer surface 14 of the support means with an adhesive layer 16 (fig. 6), which adhesive layer 16 may be made of the same material as the adhesive layer 13. Since the device is wound more than one turn, the portion of the outer surface 14 covered by the layer 16 may be limited to the portion covered by the outer surface 15 of the device. Of course, the layer 16 increases the stiffness of the different belt sections in which it is present.

Fig. 7 shows curves C1 to C6 representing the elasticity of the elements forming the support device 1-2 or 1-3. Each curve C1 to C6 shows the variation in the pulling force applied to each element as a function of the percentage of stretch (abscissa) of that element. Curve C1 represents the longitudinal elasticity of band 11. Curve C2 represents the longitudinal elasticity of the pad 21. Curve C3 represents the lateral elasticity of pad 21. Curve C4 represents the longitudinal elasticity of the individual belt 12. Curve C5 represents the longitudinal elasticity of the fabric layer 23 of the pad 21. Curve C6 represents the cross-directional elasticity of the fabric layer 23 of the pad 21. Curves C1 to C6 are substantially hyperbolic curves passing from the origin (coordinates 0%, 0N). Curves C1-C4 also have a region between 0 and 80% where the stretch is approximately proportional to the applied stretching force.

As shown by curves C1 and C2, the belt 11 stretched approximately 147% and the pad 21 stretched approximately 129% under tensile forces of 41N and 45N, respectively. Curves C1 and C2 show in particular that between 5 and 40N of tension, the belt 11 stretches 23% to 43% more than the pad 21. According to curve C3, the pad 21 is stretched 35% in the transverse direction under a tensile force of 47.5N. Therefore, the pad 21 has lower elasticity in the lateral direction than in the longitudinal direction (curves C2, C3). This arrangement prevents the edges and central region of the pad 21 from stretching at different elongations. This difference in stiffness is imparted by the fabric layer 23 forming the pad 21. In fact, according to the curves C5 and C6, under a tensile force of 32N, the fabric layer 23 is elongated 124% in the longitudinal direction and 34% in the transverse direction. As shown by curve C4, the belt 11 alone extended 147% under a 19.5N pull.

According to one embodiment, the fabric layer 23 has a stiffness in its direction of attachment to the belt 11 that is 2 to 4 times greater in the transverse direction than in the longitudinal direction of the belt 11.

Fig. 8 shows the stiffness curves C7, C8, C9 for the belt sections 10, 30 (belt 11) of the support device 1-2 or 1-3, respectively, for the cushion 21 alone, and for the section 20 combining the belt 11 and the cushion 21. According to curve C7, the stiffness of the

sections

10, 30 varies between 0.6N% and 1.25N/% when the elongation of these sections is between 5% and 130%. According to curve C8, the longitudinal stiffness of the pad 21 varies between 1.25N% and 2.1N/% when the longitudinal elongation of the pad 21 is between 5% and 130%. According to curve C9, the stiffness of the belt section 20 (pad 21+ belt 11) varies between 1.8N% and 3.3N% when the elongation of the belt section is between 5% and 130%.

Fig. 8 also shows a curve C10 representing the change in the stiffness ratio of the band section 20 and the

section

10 or 30 of the support device 1-2 or 1-3. For elongations varying between 5% and 130%, the ratio varies between 2.6 and 3.3. Thus, in the example of the support device 1-2 or 1-3, the stiffness of the band segment 20 is on average 3 times greater than the stiffness of the

band segments

10 and 30. Due to the presence of the

sections

10, 30, the support device can be adapted to different limb or joint sizes without having to significantly increase its traction around the limb or joint, while having fixed attachment points at its ends. In contrast, the belt segments 20 may withstand high traction forces without significant stretching. It can therefore distribute a relatively high pressure to the area it covers. Thus, in the example of fig. 7 and 8, the belt section 20 stretches approximately 3 times less than the

belt section

10 or 30 under the same traction force.

According to one embodiment, the support means is configured in the form of a sleeve by attaching together the opposite ends of the strap 11, as shown in fig. 9A, 9B.

Fig. 9A, 9B show the support device 1-4 in two different configurations to illustrate the use of the support device. It should be noted that both configurations can be obtained equally using any of the support devices 1, 1-1 to 1-3 in the form of a belt, as long as it is wrapped around a limb or joint and attached. In the example of fig. 9A, 9B, the support device 1-4 comprises two

belt segments

10, 20, the belt segment 20 having a greater stiffness than the belt segment 10. In fig. 9A, the support device 1-4 has been fitted around the limb or joint 5 with a uniform tension around the limb. In the configuration of fig. 9A, the belt segment 20 has a length L1. In this configuration, the support device 1-4 exerts a compressive force on the skin that is substantially constant around the limb or joint 5 and is associated with the cumulative elongation of the two

strap sections

10 and 20 that determines the different stiffness values of the two

strap sections

10, 20.

In fig. 9B, the support device has been fitted around the limb or joint by applying a greater traction force to the strap section 20 than that applied to the strap section 10. In the configuration of fig. 9B, the belt segments 20 reach a length L2 that is greater than the length L1. This configuration is somewhat stable in the absence of traction forces due to the adhesion of the inner surface of the belt section 20 to the area covered by the support device 1-4 that occurs in the presence of the compression pressure exerted by the device 1-4. The configuration of the device 1-4 in fig. 9B may be obtained from the configuration of fig. 9A, for example, by holding each end of the strap section 20 with one hand and further stretching the strap section around the limb 5. As a result, in the configuration of fig. 9B, the belt section 10 has a smaller elongation than that of the configuration of fig. 9A, so it exerts less pressure.

In the configuration of fig. 9B, the belt segment 20 exerts a greater compressive force on the area of the component it covers than the compressive force exerted by the belt segment 10 in the configuration of fig. 9A or 9B. Furthermore, the belt section 20 in the configuration of fig. 9B exerts a lower pressing force on the area of the component it covers than the pressing force exerted by the belt section 10 in the configuration of fig. 9A. The support device may thus be fitted around a limb or joint so as to apply a lower compression pressure in a particular area covered by the belt section 10 and a higher pressure in another area covered by the belt section 20.

According to one embodiment, the support device 1-4 comprises a cushion 3 of viscoelastic material attached on the inner surface of the device, designed to contact the area covered by the device. In the example of fig. 9A, 9B, the cushioning pad 3 is attached on the inner surface of the pad 21. The cushion pad 3 is designed to apply a higher pressure in a localized area. The cushioning pad 3 may have a shape adapted to the area of the skin to which higher pressure should be applied. The position of the cushion 3 can be selected by the user. For this purpose, the cushion pad 3 and the pad 21 may be a silicone gel (PDMS) having a property of being naturally attached to another element formed of the same material in a detachable manner.

The sleeves shown in fig. 9A, 9B may be designed to help strengthen the connection between the periosteum and the tibia. For this purpose, the band section 20 can be placed on the tibia, while the band section 10 covers the rear part of the leg, which consists of muscles and tendons that should not be compressed. By pulling the strap section 20 under a greater traction force than that applied to the strap section 10, the device 1-4 applies a higher pressure concentrated on the front region of the leg, while applying a lower pressure on the muscle mass at the back of the leg. The pressure exerted on the front region of the leg contributes to the support of the tibio-periosteal region, which is highly dominant, in particular during sports exercises, so that this part of the body is subjected to repeated strong vibrations and strong traction, in particular exerted to the muscular stop points present in this part of the body. The sports involved include running, dancing, and racquet sports such as tennis and squash. The presence of a looser band section 10 is particularly important as it avoids the haemostatic effect on the lower leg which is strongly swollen when it is tightened.

Fig. 10 and 11 show an orthosis 4 which is suitable, for example, for supporting the ankle after trauma or has a slack which proves that the formal support or the support from the proprioceptive point of view is correct. The orthosis 4 comprises at least a partially elastic layer 40 forming a sleeve shaped to press against the ankle and the foot 6, the sleeve having a proximal opening 40b for the passage of the foot and the leg, a distal opening 40d for the exit of the foot 6, and a central opening 40a for the heel. The layer 40 is at least partially elastic. Layer 41a is attached to layer 40 to form a first pocket into which a first pad 42a of thermoformable material is inserted. The shape of the first pocket conforms to the shape of pad 42 a. Thus, the degree of filling of the pouch with the pad may be between 80% and 95%. The shape of the pad 12 itself may be defined according to the area of the limb or joint to be secured for support. A first bladder is formed on layer 40 at a location corresponding to the lateral ankle and extends laterally between

openings

40a and 40d and between a proximal opening 40b of layer 40 and a portion 40c of layer 40 covering the side of foot 6 between the sole and the instep area. The shape of the pad 42a is shown in fig. 10A. The first pocket is formed by attaching layer 41a to layer 40 by way of fastening line 43 a. The first pouch, for example, has an opening along the proximal opening 40b of the sleeve 40 for inserting the pad 42a into the pouch or removing the pad 42a from the pouch. The layer 40 may be in direct contact with the skin 6 of the user. Layer 41a may be attached to layer 40 by a weld line or seam 43a on one or the other side of layer 40.

According to one embodiment, orthosis 4 includes a second pad 42b made of thermoformable material that is placed in a second pocket formed on layer 40 at a location configured to cover the inner ankle and extending laterally on layer 40 around the inner ankle to opening 40b of the sleeve. The shape of pad 42b is shown in fig. 11A. Second pocket 42b is formed using a fabric layer 41b attached to sleeve 40 by fastening threads 43 b. The second pouch may also have an opening along the proximal opening 40b of the sleeve 40 for inserting the pad 42b into the pouch or removing the pad 42b from the pouch.

It should be noted that fig. 10A and 11A illustrate the shape of the

pads

42a, 42b before they are thermoformed directly over the foot. After the thermoforming operation, the

pads

42a, 42b take the precise shape of the ankle and surrounding area.

A strap 1' (a portion of which is shown in fig. 10, 11) designed to wrap around and secure around the foot 6 and ankle may be used to further secure the

pads

42a, 42b against the ankle and thus integrate the

pads

42a, 42b with the ankle. The strap 1' can be sewn or hooked onto the orthosis 4 by attachment means on the orthosis 4 comprising, for example, one or more hooks 45, each of which cooperates with a loop 46 in the end region of the strap 1.

The orthosis 4 can be used in the following manner. Prior to first use, the orthosis should undergo a thermoforming operation. To this end, the orthosis is heated, for example by immersing it in hot water at a temperature sufficient to soften the

pads

42a, 42b with the

pads

42a, 42b in their respective pockets. After they have been in contact with the hot water for a certain time, the

pads

42a, 42b soften. Before the

pads

42a, 42b regain their rigidity, the user places the orthosis 4 around the ankle to be supported. The resilient traction of the layer 40 presses the

pads

42a, 42b against the user's skin. The

pads

42a, 42b then take the shape of the area against which they are pressed and harden after a few minutes. During stiffening of the

pads

42a, 42b, the ankle is maintained in a desired final position. Thus, by thermoforming the

pads

42a, 42b, the orthosis 4 adapts to the configuration of the location to which it is applied, the resilience applied by the layer 40 ensuring retention and deformation of the previously softened

pads

42a, 42b simply by fitting the orthosis over the ankle. The operation does not require the intervention of another person and in particular a professional.

The portion of the limb or joint to be supported may be covered with a film, such as a plastic film, prior to the thermoforming operation, to facilitate removal of the wet brace at the end of the thermoforming operation.

The

pads

42a, 42b are made of a material such as "Aquaplast" manufactured by Patterson, for example. They have a thickness of between 1.5mm and 5mm, for example about 2.4 mm. The material softens and remains extensible for about 4 minutes at 65-75 deg.C. Thus, the thermoforming operation of the

pads

42a, 42b may be repeated as many times as desired.

Fig. 12 shows an exemplary embodiment of a strap 1' attachable to an ankle orthosis 4. The strap 1' is configured to wrap around the ankle and foot 6. To this end, the strap 1 'comprises a main portion 1a and a secondary portion 1b fixed to the main portion 1a, the strap 1' thus having a general T-shape. The belt portion 1b partially covers the portion 1a and thus enhances the support achieved by the latter. The belt portions 1a, 1b have a structure similar to that of the device 1. In the example of fig. 12, the belt portions 1a, 1b have the same structure as the device 1-2. Thus, the main portion 1a includes

band sections

10a, 20a, 30a of different stiffness values-such as

band sections

10, 20, 30, a pad 21a similar to pad 21, which forms band section 20a with band portion 1 a. The pad 21a is attached to the inner surface of the belt portion 1a, for example, by a seam 17 a. The minor band portion 1b also includes

band segments

10b, 20b, 30b of different stiffness values-such as

band segments

10, 20, 30, a pad 21b similar to pad 21, which together with band portion 1b forms band segment 20 b. The pad 21b is attached to the inner surface of the belt portion 1b, for example, by a seam 17 b. One end of the belt portion 1b is attached, for example, by a seam 17c, on the outer surface of the belt portion 1a opposite to the inner surface to which the pad 21a is attached.

One end of the strap portion 1a is first attached to the orthosis 4, for example by means of a loop 46 and a hook 45 on the upper part of the orthosis in the lower region of the lower leg. The strap 1' can also be sewn to the orthosis 4. In a first step, the strap portion 1a is wrapped around the ankle a little more over the rear half turn of the ankle without traction, then wrapped around the foot on top of the foot, and finally wrapped under the foot. The user may then place his foot on the ground to hold one end of the section 20a of the belt portion 1a in place, and then wrap around the section 20a while applying stronger traction onto the free end of the belt portion 1 a. Section 20a then stretches slightly while covering the lower portion of pad 42a that is pressed against the foot. Then, by moving backwards, the band covers the pressure insensitive upper part of the arch, avoiding the very sensitive lower part of the arch where it would interfere with the dorsiflexion of the foot. Finally, section 20a covers most of pad 42b (and in particular the portion of pad 42b that covers the inner ankle). Once the section 20a is wrapped around the ankle, the traction on the free end of the strap portion 1a is released and its free end is attached near the loop 46 by means of a further hook and loop arrangement 47 provided for this purpose. Due to the adhesion of the inner surface of the section 20a, it keeps it elongated, in particular when the end of the belt 1a is attached. The band section 20a thus forms a secure connection between the two

pads

42a, 42 b.

The end of the belt portion 1b attached to the belt portion 1a is then parallel to the underside of the foot on the medial side of the foot. The belt portion 1b is wound on the foot a little more around the ankle in half a turn without traction and then wound behind the ankle so that the pad 21b is in contact with the belt portion 1 a. The free end of strap portion 1b is then attached to strap portion 1a near loop 46 by another attachment means such as a hook and loop 48. In this configuration of strap portion 1b, strap section 20b covers an upper portion of pad 42a, thereby holding it against the ankle.

Fig. 13 shows curves C11, C12 illustrating the change in traction of the strap 1' after it has been wrapped around the foot and orthosis at a position along the strap. The belt sections 1a, 1b are divided before stretching into numbered sections of equal length, the section numbers being presented on the abscissa. Thus, in fig. 13, the band portion 1a corresponding to the curve C11 extends over the section numbered 1 to 14, while the band portion 20a extends over the section numbered 6 to 11. The belt portion 1b corresponding to the curve C12 is attached to the belt portion 1a between the sections numbered 4 and 5, extending over the sections numbered 5 to 10, and the belt portion 20b extending over the sections numbered 7 and 8.

According to curve C11, the belt portion 1a is wound up to the section numbered 3 without traction. Before the segment numbered 4, the traction applied by the tape portion 1a increases slightly from 0 to 0.2N. The traction force is further increased to reach 2.72N at the segment numbered 6 corresponding to the start of the segment 20 a. Section 20a applies a traction force that gradually increases to a value near 16N near the sections numbered 8 and 9. The traction exerted by the belt portion 1a then gradually decreases until the end of the belt 1a at the section numbered 14 reaches a value close to zero. At the junction with the band segment 20a, the band segment 10a reaches an elongation of about 15%. The elongation of the band section 20a gradually increases from 8% to 45% between the sections numbered 6 and 8, and then decreases to 15% at the section numbered 11. The elongation of the belt segment 30a gradually decreases from 25% to 5% between the sections numbered 12 and 14.

According to curve C12, the belt section 1b is wound up to a slight traction of 0.2N, which increases to 2.25N at the section numbered 6. The traction force is zero or near zero along the belt section 20b and reaches 0.2N at the end of the belt section 1b at the section numbered 10. The elongation of the belt section 10b increases from 5% to 13% between the sections numbered 5 and 6. The elongation of the belt section 20b is zero and the elongation of the section 30b is 5%.

When the strap is wrapped around the orthosis and foot, section number 9 (the middle portion of the pad 21 a) covers

sections

3 and 4 of strap portion 1 a. The sections numbered 7 and 8 (pads 21b) cover the sections numbered 9 and 14 of the belt portion 1 a. Section number 9 of belt portion 1b overlaps section number 12 of belt portion 1 a. The pressing forces exerted by the different overlapping sections add up.

Since the strap section 20b is not adapted to stretch, the pad 21b may be made of a non-elastic material. Along the strap 1', the retention of the different traction forces applied, possibly differing by 20N, is ensured by the self-attaching of the strap and the attaching on the orthosis.

The

sections

20a, 20b of the strap 1' which are tighter and stiffer thus keep the

pads

42a, 42b against the ankle just like an ankle splint, section 20b complements the action of section 20a in supporting the ankle at three points-namely at the bottom and top of pad 42a and at pad 42 b. The strap 1' does not exert excessive pressure on the arch of the foot and on the lower tibial strap just above the ankle covered by the more lax and

soft segments

10a, 30a, 10b, 30 b. In addition, the

sections

10a, 30b can be more or less stretched to properly seat the

sections

20a, 20b on the

pads

42a, 42b depending on the user's posture, without the pressure they exert on the ankle area they cover changing appreciably.

The support loops of the belt portions 1a, 1b and the ends of the hooks 45 to 47 may be reinforced by a non-elastic piece of fabric.

It will be apparent to those skilled in the art that the present invention may have various alternative embodiments and various applications. In particular, the invention is not limited to the described embodiments, but extends to all possible combinations of these embodiments.

Furthermore, the inner surface 15 of the device 1, 1-3 or 1-4, the strip 11 or the strip 1' of the device 1-2 may be obtained by means of viscoelastic elements, such as studs, for example, distributed in a uniform manner on the surface 15. The density of the viscoelastic elements on the inner surface 15 may be chosen according to the adhesion to be obtained by taking into account the compaction pressure exerted by the device and the adhesion of the individual viscoelastic elements.

Although the examples described apply to the fixation of the periosteum and the support of the ankle, the invention is applicable to any part of the body where it is desirable to selectively apply pressure in one or more different areas.

Claims

1. A support or compression device configured to wrap around a limb of a user, comprising an elastic band having two band segments of different stiffness values, the elastic band having an outer surface and an inner surface opposite the outer surface, the inner surface being in contact with the skin of the user and a covered portion of the outer surface when the elastic band is wrapped around the limb of the user and wrapped over itself, the inner surface of the elastic band having an attachment to the covered portion such that, in combination with a compression pressure exerted by the elastic band when the elastic band is wrapped around the limb of the user and locally stretched under different local traction forces, the elastic band is capable of retaining local elongation caused by the different local traction forces after removal of the different local traction forces.

2. The device of claim 1, wherein a first of the two strap sections comprises a pad made of an elastic material attached to the elastic strap by two opposing ends.

3. The device of claim 2, wherein the pad is attached on an inner surface of the elastic band.

4. The device of claim 2, wherein the pad is attached on an outer surface of the elastic band.

5. The device of claim 2, wherein the pad comprises a layer of viscoelastic material and a layer of elastic fabric attached to the layer of viscoelastic material.

6. The device of claim 5, wherein the elastic fabric layer has a lower stiffness in a longitudinal direction of the elastic band than in a transverse direction.

7. The device according to any one of claims 1 to 6, wherein a first of the two strap sections has a stiffness between 2 and 4 times that of a second of the two strap sections.

8. The device of any one of claims 1 to 6, wherein the inner surface is formed from a layer of polymer gel.

9. The device of claim 8, wherein the inner surface is formed from a layer of polydimethylsiloxane.

10. The device of any one of claims 1 to 6, wherein the inner surface of the elastic band has an attachment to the covered portion that can maintain the elongation caused by the difference in tension of 20N in the presence of compressive pressure applied when the elastic band is wrapped around the limb under traction.

11. A device according to any one of claims 1 to 6, comprising first and second strap portions configured to wrap around the ankle and foot, the first strap portion comprising a first strap section having a higher stiffness than other strap sections of the first strap portion, the second strap portion having an end secured to an outer surface of the first strap portion and a second strap section having a higher stiffness than other strap sections of the second strap portion, wherein the first and second strap sections of higher stiffness are arranged on the first and second strap portions respectively in such a way that they can cover both the area below and above the lateral malleolus of the ankle as well as the medial malleolus.

12. A support or compression device configured to wrap around a user's joint, comprising an elastic band having two band segments with different stiffness values, the elastic band having an outer surface and an inner surface opposite the outer surface, the inner surface being in contact with the user's skin and a covered portion of the outer surface when the elastic band is wrapped around the user's joint and wrapped over itself, the inner surface of the elastic band having an attachment to the covered portion such that, in combination with a compressive pressure exerted by the elastic band when the elastic band is wrapped around the user's joint and stretched locally under different local traction forces, the elastic band can retain local elongation caused by the different local traction forces after the different local traction forces are removed.

13. The device of claim 12, wherein a first of the two strap sections comprises a pad made of an elastic material attached to the elastic strap by two opposing ends.

14. The device of claim 13, wherein the pad is attached on an inner surface of the elastic band.

15. The device of claim 13, wherein the pad is attached on an outer surface of the elastic band.

16. The device of claim 13, wherein the pad comprises a layer of viscoelastic material and a layer of elastic fabric attached to the layer of viscoelastic material.

17. The apparatus of claim 16, wherein the elastic fabric layer has a lower stiffness in a longitudinal direction of the elastic band than in a transverse direction.

18. A device according to any one of claims 12 to 17 wherein a first of the two strap sections has a stiffness between 2 and 4 times that of a second of the two strap sections.

19. The device of any one of claims 12 to 17, wherein the inner surface is formed from a layer of polymer gel.

20. The device of claim 19, wherein the inner surface is formed from a layer of polydimethylsiloxane.

21. The device of any one of claims 12 to 17, wherein the inner surface of the elastic band has an attachment to the covered portion that can maintain the elongation caused by the difference in tension of 20N in the presence of compressive pressure applied when the elastic band is wrapped around the joint under traction.

22. A device according to any one of claims 12 to 17, comprising first and second strap portions configured to wrap around the ankle and foot, the first strap portion comprising a first strap section having a higher stiffness than other strap sections of the first strap portion, the second strap portion having an end secured to an outer surface of the first strap portion and a second strap section having a higher stiffness than other strap sections of the second strap portion, wherein the first and second strap sections of higher stiffness are arranged on the first and second strap portions respectively in such a way that they can cover both the area below and above the lateral malleolus of the ankle as well as the medial malleolus.

23. A method of manufacturing a support or compression device configured to wrap around a limb of a user according to any one of claims 1 to 11 or a support or compression device configured to wrap around a joint of a user according to any one of claims 12 to 22, the method comprising the step of assembling elastic band segments to obtain band segments having different values of stiffness.